Peer-reviewed article

Association of Halliwick-Based Aquatic Physical Activity with Health-Related Quality of Life in Children and Adolescents with Autism Spectrum Disorder: A Cross-Sectional Comparative Study.

Stefańska M, Smętek W, Kowalska J, Ptak A · 6 Oct 2026

Abstract

Background Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by persistent deficits in social communication and interaction, accompanied by restricted and repetitive patterns of behavior, interests, or activities. Given the considerable heterogeneity in symptom severity and functional abilities, children with ASD require individualized educational and therapeutic interventions. Among the non-pharmacological approaches used to support this population, aquatic physical activity has emerged as a promising intervention. Material and methods The study included 45 children with ASD (ICD-11 code 6A02), comprising 19 girls and 26 boys, aged 8-17 years. Two groups were compared: Group G1, consisting of children and adolescents who had participated in Halliwick-based aquatic physical activity for at least 3 months, and Group G2, without aquatic activities. Health-related quality of life was assessed using the validated Polish version of the KIDSCREEN-52 questionnaire. Results Children with ASD who participated in Halliwick-based aquatic physical activity (G1) had higher mean scores in all KIDSCREEN-52 domains. However, statistically significant differences were only found in the following domains: Psychological Well-Being, Moods and Emotions, Self-Perception, Autonomy, Financial Resources, and School Environment. Overall health-related quality of life, measured by the KIDSCREEN-10, compared with children who did not participate in aquatic activities. Conclusions Halliwick-based aquatic physical activity was associated with better quality of life in children and adolescents with ASD, with higher scores observed according to sex, but further research is needed to confirm these findings.